A natural woman, one bead at a time

Amanda Zamani of Asheville, N.C., never really liked hormonal birth control and its effects on her body. She had a hard time remembering to take the Pill at the same time every day, and she felt that the hormones exacerbated her emotional ups and downs.

“As a whole, I just try to avoid taking extra medications,” said the mother of two toddlers. “I don’t steer towards medicine as the first route for headaches or colds.” Fed up, she tried natural family planning. She took her temperature every morning before she got out of bed and monitored her body daily to determine when she was ovulating. But she used the method incorrectly, and in the course of two years had two unplanned pregnancies.

Then in 2006, she saw CycleBeads on sale at a health food store. A string of 32 color-coded beads, CycleBeads identify the 12 days in a woman’s menstrual cycle during which she is likely to be fertile. Being aware of the days on which pregnancy is most likely can be helpful both for women who are looking to become pregnant--and for women like Zamani who are not.

Zamani, 25, now keeps her CycleBeads in her bathroom, and moves the black ring that is used to track days onto the next bead each morning. “It’s very helpful,” she said. “I’m not planning on changing.”

Zamani is part of a small but dedicated number of women who are practicing medication-free birth control with a clinically tested approach that is part of their desire to embrace a back-to-basics lifestyle.

According to the Centers for Disease Control and Prevention’s most recent study on the use of contraception and family planning services in the United States, 0.7 percent of women were using the calendar/rhythm method in 2002, and 0.2 percent were using other natural family planning methods.

Though the rhythm method has declined over time, from 1.8 percent in 1982, other natural family planning methods have remained steady. CycleBeads work in conjunction with one of them, the Standard Days Method, which was created by the Institute for Reproductive Health at Georgetown University in 2002 and now has an estimated 50,000 users in the United States and more than half a million women around the world, according to IRH.

Over the years natural methods have not been given much credence: As the old joke goes, “What do you call people who use the rhythm method? Parents.” But the Standard Days Method is backed by research that shows it is 95 percent effective if used correctly, according to IRH. That is still not as effective as methods like the Pill (which is more than 99 percent effective when used correctly, according to Planned Parenthood), but for many women, natural family planning is a lifestyle choice beyond just birth control.

“I want to be connected to my body and know how I’m feeling,” said Suran Thrift, a freelance writer in Los Angeles. She said that her decision to use CycleBeads was “part of an overall desire to educate myself more about my health and alternative means to health.”

IRH set out to create a natural method that was actually based on research. It took data of more than 7,500 menstrual cycles obtained from the World Health Organization and calculated the probability of pregnancy on different cycle days, coming up with a formula that provided maximum protection, while minimizing the number of days of avoiding unprotected intercourse.

The Standard Days Method has a longer window of consecutive days of possible fertility than most other natural methods, and it only works for the estimated 80 percent of women who have regular cycles of 26 to 32 days. But with perfect use, it is effective 95 percent of the time, according to a study done by IRH. It has been particularly popular in developing nations, where contraception resources are scarce.

“To our surprise, people in other settings where family planning was readily available – there was a spark of interest there as well,” said the IRH director, Dr. Victoria Jennings. “There has become more interest in a method that works with your body and that maybe helps you learn something about your body, as opposed to a method that suppresses your body’s normal function.”

Methods like the Pill and intrauterine device have been proven to be safe and effective, but some women do experience side effects like nausea or emotional ups and downs with the Pill and cramps or backaches with the IUD. But what confounds experts like Dr. Rebekah Gee, an obstetrician/gynecologist and clinical scholar at the University of Pennsylvania, though, is the lack of knowledge among women concerning what is happening inside the body.

“It’s amazing what women don’t know about their bodies and their cycles,” said Dr. Gee. “Anything that they can use that helps them better understand their cycles and when they’re at risk for getting pregnant is a good thing.”

Leslie Heyer, president of Cycle Technologies, the maker of CycleBeads, said interest in the beads has been greater in the West Coast, particularly in California and the Pacific Northwest, followed by the Northeast and the mid-Atlantic states. Revenue has doubled each year since they were introduced in October 2002; last year, 60,000 units were sold.

A key target is the holistic buyer. “They tend to be very aware of what they put into their bodies, very concerned about what’s in their food,” she said. “They might even be unwilling to take medications.”

In addition, many women turn to natural family planning methods when they reach a point in their lives where pregnancy is no longer to be avoided at all costs.

According to an online survey of customers, Heyer said users tended to be between the ages of 25 and 39, and most said they were in relatively stable relationships. Kristin Walsh, the president of the New York State Association of Licensed Midwives, concurred, saying that of the women she has seen who seek the services of midwives, “The picture of someone who uses natural family planning is overwhelmingly someone in a committed, monogamous relationship, usually married.”

Still, there are other natural methods that require women to have much deeper knowledge of their bodies; as a result, some don’t consider SDM a fertility awareness-based method at all.

“They’re not actually becoming aware of the symptoms of fertility,” said Ilene Richman, coordinator of the Fertility Awareness Network, a nonprofit group. Richman teaches the sympto-thermal method, which involves the monitoring of body temperature and cervical mucus, and calendar calculation of each woman’s particular cycle. “It’s not based on their body, it’s based on statistics,” she said of the SDM.

But for women like Zamani, even a general awareness of fertility is a step in the right direction. “I think even when my daughter is old enough and starts her cycle, I would get them for her,” Zamani said of CycleBeads. “Just to be aware of her cycle better than I was when I was younger.”